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Clinicopathological Features of Epstein-Barr Virus-associated Intrahepatic Cholangiocarcinoma

Prakasit Sa-Ngiamwibool¹, Siraphong Putraveephong², Aumkhae Sookprasert², Attapol Titapun³, Kosin Wirasorn², Atibordee Meesing⁴, Piyakarn Watcharenwong², Prin Twinprai⁵, Jarin Chindaprasirt²

Affiliation : ¹ Division of Pathology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand, ² Medical Oncology Program, Division of Internal Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand, ³ Division of Surgery, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand, ⁴ Infectious and tropical disease Program, Division of Internal Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand, ⁵ Division of Radiology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand

Background: Epstein-Barr virus (EBV) was found to be associated with many cancers. Only a few cases of EBV-associated cholangiocarcinoma were reported and most of them were lymphoepithelioma-like tumors. The objective of this study was to determine the prevalence of EBV in intrahepatic cholangiocarcinoma in the Thai population.
Materials and Methods: A total of 40 cholangiocarcinoma tumors were retrieved by simple random sampling. EBV status was assessed by EBV-encoded small RNA (EBER) in situ hybridization from formalin-fixed paraffin-embedded (FFPE) tumor samples. The association between EBV status and clinicopathological characteristics was analyzed using Fisher’s exact test, and survival analysis was done using the Kaplan-Meier method.
Results: Out of 40 intrahepatic cholangiocarcinoma tumor samples, 3 (7.5%) were positive for EBV by EBER in situ hybridization. The median age of EBV-positive patients was lower than the EBV-negative group (52 vs. 64 years). All three EBV-positive intrahepatic cholangiocarcinoma cases were presented in stage I (T1N0M0). Two patients were well-differentiated adenocarcinoma and 1 was mucinous cystadenocarcinoma. There was a trend toward better survival was seen in EBV-positive patients (p=0.085).
Conclusion: EBV-associated intrahepatic cholangiocarcinoma is rare, only 7.5%, even in the endemic area.

DOI:10.35755/jmedassocthai.2023.S01.13756

Keywords : Biliary duct cancer; Intrahepatic cholangiocarcinoma; Epstein-Barr virus (EBV); EBV-associated cancer; EBER


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